INTRODUÇÃO. Estudos anteriores demonstraram que pacientes com síndrome metabólica (SMet) e apnéia obstrutiva do sono (SAOS) apresentam hiperativação simpática e hipersensibilidade quimiorreflexa. Neste trabalho, testamos as hipóteses de que: 1) dieta hipocalórica associada à treinamento físico (D+TF) melhora a sensibilidade quimiorreflexa em pacientes com SMet e 2) Os efeitos da D+TF seriam mais pronunciados em pacientes com SMet+AOS que em pacientes sem AOS (SMet-AOS). MÉTODOS. Vinte e sete pacientes nunca tratados da SMet (ATP-III) foram alocados em: 1) SMet+AOS (n = 15, 53±2 anos) e 2) SMet-OSA (n = 12, 43±2 anos). A AOS foi caracterizada por um índice de apnéia-hipopnéia (IAH)> 15 eventos / hora (polissonografia). Atividade nervosa simpática muscular (ANSM) foi avaliada pela técnica de microneurografia e pressão arterial (PA) pelo método oscilatório. A sensibilidade quimiorreflexa periférica foi avaliada através da inalação de uma mistura gasosa contendo 10% O2 e 90% N2 com titulação de CO2; e a sensibilidade quimiorreflexa central através da inalação de 7% CO2 e 93% O2 por 3 min. A dieta hipocalórica foi de -500 kcal da taxa metabólica de repouso e o treinamento físico se estendeu por 4 meses, 3 vezes/ semana. RESULTADOS. A associação da D+TF reduziu semelhantemente peso corporal (5,5±0,7 e 6,2±0,6 kg, P = 0,44), circunferência abdominal (CA, 5,6±1,2 e 5,4±1,0 cm, P = 0,91), PA sistólica (10,9±3,2 vs 13,3±3,5 mmHg, P = 0,62) e diastólica (8,5±1,6 vs 8,3±1,4 mmHg, P = 0,95) e, similarmente, o aumento do consumo de oxigênio de pico (20±5,9 e 16±7,3%, P = 0,69) em pacientes com SMet+AOS e SMet-AOS. A D+TF, reduziu significativamente o IAH (38±6,2 vs 18±3,9 eventos / hora, P = 0,01) e aumentou a saturação mínima de O2 (81±2,3 vs 84±1,9 %, P = 0,01) em pacientes com SMet+AOS. Durante a estimulação hipóxica, D+TF reduziu significativamente os níveis de ANSM tanto em pacientes com SMet+AOS (41±1,9 versus 33±2,0 impulsos/ min, P = 0,02) como em SMet-AOS (36±3,2 versus 28±1,7 impulsos/ min, P = 0,05). Durante a estimulação hipercápnica, D+TF reduziu significativamente os níveis de ANSM em pacientes com SMet+AOS (39±2,0 versus 30±1,1 impulsos/ min, P = 0,0005), mas não em pacientes com SMet- AOS. CONCLUSÕES. Tratamento não-farmacológico como D+TF melhora o controle quimiorreflexo periférico da ANSM em pacientes com síndrome metabólica. Esta mudança autonômica é mais pronunciada em pacientes com SMet+AOS, nos quais D+TF melhora tanto o controle quimiorreflexo periférico como o central. Além disso, D+TF melhora o distúrbio do sono em pacientes com SMet+AOS. Sendo assim, estes resultados sugerem que D+TF pode reduzir o risco cardiovascular em pacientes com SMet e AOS / INTRODUCTION. Previous studies have shown that patients with metabolic syndrome (MetS) and obstructive sleep apnea (OSA) have sympathetic hyperactivation and chemoreflex hypersensitivity. We tested the hypothesis that: 1) Hypocaloric diet associated with exercise training (D+ET) would improve chemoreflex sensitivity in patients with MetS and 2) The effects of D+ET would be more pronounced in patients with MetS+OSA than in patients without OSA (MetS-OSA). METHODS. Twenty three never treated MetS patients (ATP-III) were allocated into: 1) MetS+OSA (n=15, 53±2 yrs); and 2) MetS-OSA (n=12, 43±2 yrs). OSA was characterized by an apnea-hypopnea index (AHI) >15 events/hour (polysomnography). Muscle sympathetic nerve activity (MSNA) was evaluated by microneurography technique and blood pressure (BP) by oscillatory method. Peripheral chemoreflex sensitivity was evaluated by inhalation of 10%O2 and 90%N2 with CO2 titrated, and central chemoreflex by 7%CO2 and 93%O2 for 3 min. The hypocaloric diet was set at -500 kcal of the resting metabolic rate and exercise training extended over 4 months, 3 times/ week. RESULTS. D+ET similarly reduced body weight (5.5±0.7 and 6.2±0.6kg, P=0.44), waist circumference (WC, 5.6±1.2 and 5.4±1.0 cm, P=0.91), systolic BP (10.9±3.2 vs. 13.3±3.5 mmHg, P=0.62) and diastolic BP (8.5±1.6 vs. 8.3±1.4 mmHg, P=0.95), and similarly increased peak oxygen consumption (20±5.9 and 16±7.3%, P=0.69) in MetS+OSA and MetS-OSA patients. D+ET significantly reduced AHI (38±6.2 vs. 18±3.9 events/hour, P=0.01) and minimal O2 saturation (81±2.3 vs. 84±1.9%, P=0.01) in MetS+OSA patients. D+ET significantly reduced MSNA levels during hypoxia in MetS+OSA (41±1.9 vs. 33±2.0 bursts/min, P=0.02) and MetS-OSA (36±3.2 vs. 28±1.7 bursts/min, P=0.05) patients. D+ET significantly reduced MSNA levels during hypercapnia in MetS+OSA patients (39±2.0 vs. 30±1.1 bursts/min, P= 0.0005), but not in MetS-OSA patients. CONCLUSIONS. Non-pharmacological treatment based on D+ET improves peripheral chemoreflex control of MSNA in patients with MetS. This autonomic change is more pronounced in patients with MetS+OSA, in whom D+ET improves both peripheral and central chemoreflex controls. In addition, D+ET improves sleep disorder in patients with MetS+OSA. Altogether, these findings suggest that D+ET reduce cardiovascular risk in patients with MetS+OSA

Introdução: A síndrome metabólica (SM) é frequente em idosos. A alimentação influencia a prevalência, constituindo uma das variáveis de risco modificáveis, com impacto positivo no controle da doença. Objetivo: Verificar a associação entre SM e padrões alimentares de indivíduos idosos do município de São Paulo. Métodos: Estudo transversal que utilizou os dados do Estudo SABE: epidemiológico, de coortes e de base domiciliar. A população deste estudo incluiu idosos ( 60 anos), de ambos os sexos, selecionados por amostra probabilística, e entrevistados em 2010, pertencentes a três coortes A/2000 (n=630), B/2006 (n=214) e C/2010 (n=311). As variáveis de estudo foram: a) referidas: sexo, idade, escolaridade, ingestão de bebida alcoólica, tabagismo, atividade física e número de doenças crônicas não transmissíveis; b) mensuradas: SM, identificada segundo os critérios do National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) sendo circunferência da cintura > 102 cm, para homens, e > 88 cm, para mulheres; pressão arterial 130 e/ou 85 mmHg (obtidas por entrevistadores previamente treinados); triacilgliceróis 150 mg/dL; High Density Lipoprotein (HDL) colesterol < 40 mg/dL, para homens e < 50 mg/dL, para mulheres; glicemia de jejum >100 mg/dL (por meio de amostra sanguínea); obesidade, classificada pelo índice de massa corporal 30kg/m2. Os dados de alimentação foram obtidos por meio de entrevista domiciliar registrando-os em formulário específico, com 107 alimentos, classificados em 18 grupos de alimentos. Os padrões alimentares foram determinados pela análise fatorial exploratória por componentes principais. Foram utilizados teste de qui-quadrado de Rao & Scott para amostragem complexa, bem como regressão logística múltipla, com nível de significância de 5 por cento . O programa estatístico STATA 13.1 foi adotado para os cálculos. Resultados: 1.155 indivíduos foram estudados e a prevalência de SM foi de 57,9 por cento . Quatro padrões alimentares foram identificados: padrão 1, composto por: frituras, embutidos, enlatados, doces, tubérculos, temperos/molhos industrializados e ovos, denominado inadequado; padrão 2, laticínios desnatados, cereais e pães integrais e alimentos light, diet ou zero, denominado padrão modificado; padrão 3, óleos vegetais, arroz, cereais refinados e pão branco, carnes e leguminosas, denominado padrão tradicional brasileiro; e, padrão 4, frutas, verduras e legumes e tubérculos, denominado benéfico. O padrão modificado foi associado positivamente à SM. Idosos do 4º quartil do padrão modificado aumentaram em 60 por cento o risco da presença de SM. O padrão benéfico foi associado negativemente à SM, em idosos 70 anos (coorte A). Os padrões inadequado e tradicional brasileiro não foram associados significativamente à SM. Conclusão: O padrões alimentares modificado e benéfico estiveram associados a SM. Indivíduos do padrão modificado apresentaram aumento do risco de SM, e do padrão benéfico redução do risco para idosos mais velhos. A associação ao padrão modificado pode ser devido à mudanças alimentares implementadas no dia a dia dos indivíduos idosos, após diagnóstico de anormalidades metabólicas. / Introduction: Metabolic syndrome (MS) is common in elderly people. The feeding influences its prevalence constituting one of the modifiable risk factor, with positive impact on the disease control. Objective: To investigate the association between MS and dietary patterns of older adults from São Paulo city. Methods: Cross-sectional study that used data from the SABE survey: epidemiological, cohort based and home-dweling. The study population included elderly individuals ( 60 years old), both sexes, selected by probability sampling, and interviewed in 2010, belonging to three cohorts A/2000 (n = 630), B/2006 (n = 214) and C / 2010 (n = 311). The study variables were: a) referred: gender, age, education, alcohol consumption, smoking, physical activity, number of chronic noncommunicable diseases; b) measured: MS, identified according to the criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII): waist circumference > 102 cm for men, and > 88 cm for women; blood pressure 130 and/or 85 mmHg (obtained by trained interviewers); triglycerides 150 mg/dL; high density lipoprotein cholesterol < 40 mg/dL for men, and < 50 mg/dL for women; fasting glucose > 100 mg/dL (through blood samples); obesity, c classified by body mass index 30 kg/m2. The feeding data were obtained by one specific food frequency questionnaire with 107 foods, classified into 18 food groups. Dietary patterns were determined by exploratory factor analysis of principal components. Rao & Scott and multiple logistic regression for complex sample were used, with 5 per cent significance level. The statistical software STATA 13.1 was adopted for calculations. Results: 1155 subjects were studied. The prevalence of MS was 57.9 per cent . Four dietary patterns were identified: pattern 1, composed by fried foods, sausages, canned foods, sweets, tubers, spices/sauces and processed eggs, called inappropriated; pattern 2, composed by low-fat dairy products, whole grain cereals and breads, and light, diet or zero food, called modified; pattern 3, composed by vegetable oils, rice, refined cereals and white bread, meat and legumes, called Brazilian traditional pattern; and pattern 4, fruits, vegetables and tubers, called beneficial. The modified pattern was positively associated to MS. 4th quartile modified pattern older adults had increased in 60 per cent the risk of MS. The beneficial pattern was negatively associated to MS, in the older individuals ( 70 y, cohort A). The inappropriated and Brazilian traditional patterns were not significantly associated to MS. Conclusion: The modified and beneficial dietary patterns were associated to MS. Modified individuals pattern showed increased risk of MS. Beneficial pattern reduced the risk to the oldest older individuals. The modified pattern could be due to dietary changes implemented in the older adults daily life after diagnosis of metabolic abnormalities. .

Crescem a cada dia os índices globais de obesidade associada à síndrome metabólica (SM) e à inflamação. Sob este aspecto, os compostos fenólicos (CFs) exercem papel importante, especialmente no que diz respeito às suas propriedades anti-inflamatória e antiobesogênica. A jabuticaba Sabará (Myrciaria jaboticaba (Vell.) Berg) é uma fruta nativa bem aceita pelos brasileiros e rica em CFs. O objetivo deste trabalho foi avaliar o efeito da administração diária de extratos ricos em CFs desta fruta a camundongos C57BL/6, alimentados com dieta hiperlipídica com alto teor de sacarose (HFHS) por 8 semanas. Os extratos ricos em CFs foram obtidos por extração do fruto inteiro em solução metanol/água (80:20, v/v), seguida de rotaevaporação e extração em fase sólida (EFS). Os animais foram distribuídos em 5 grupos: o grupo Padrão recebeu dieta padrão de laboratório e veículo (água) por gavagem, o grupo HFHS recebeu dieta HFHS e veículo, o grupo EB recebeu 200 mg b. s. (base seca)/kg de peso corporal (PC) de extrato bruto (EB), o grupo C18 recebeu 50 mg EAG (equivalentes de ácido gálico)/kg de PC do extrato obtido em sorvente octadecil silano (C18) (que permite a obtenção de todos os CFs da fruta) e o grupo PA recebeu 50 mg EAG/kg de PC do extrato obtido em sorvente poliamida (PA) (que permite a obtenção de todos os CFs da fruta, exceto os elagitaninos). O grupo C18 apresentou menores ganho de peso, adiposidade e eficiência energética, comparado ao grupo HFHS. Já o grupo EB teve menor expressão gênica do fator de necrose tumoral alfa (TNF-&#945;) no tecido adiposo branco epididimal, e menor concentração deste mesmo marcador no fígado. Estes resultados sugerem que os elagitaninos têm um papel importante na redução do risco do desenvolvimento de obesidade em camundongos que receberam dieta indutora de obesidade e SM, enquanto o EB da fruta parece contribuir para a redução da inflamação destes animais, porém os mecanismos para tal ainda não estão esclarecidos. / The incidence of obesity is increasing associated with other disorders as metabolic syndrome (MS) and low-grade inflammation. Phenolic compounds (PC) have some well-known properties, such as anti-inflammatory, antidiabetic and antiobesity capacities. Jaboticaba Sabará (Myrciaria jaboticaba (Vell.) Berg) is a brazilian fruit well accepted in this country and it has a high PCs amount. The aim of this study was to investigate the effects of phenolic-rich jaboticaba extracts in C57Bl/6J mice fed a high fat/high sucrose (HF/HS) diet during 8 weeks. The phenolic-rich jaboticaba extracts were prepared from fruit extraction in methanol/water solution (80:20, v/v), followed by rotary evaporation and solid phase extraction (SPE). The mice were distributed in 5 groups: the Chow group was fed a chow diet and gavaged daily with vehicle (water), the HFHS group was fed a HF/HS diet vehicle as well, the CE group received 200 mg of jaboticaba crude extract (CE)/kg body weight (BW), the C18 group received 50 mg AGE (acid galic equivalent)/kg BW of phenolic-rich jaboticaba extract obtained by octadecyl silane (C18) sorbent (which permits to extract every PCs from the fruit) and the PA group were gavaged with 50 mg AGE/kg BW of this fruit extract obtained by polyamide (PA) sorbent (which allows to extract every PCs from jaboticaba, excepting ellagitannins). The C18 group had the lowest BW gain, adiposity and energy efficiency, compared to the HFHS group. The CE group presented low tumor necrose factor-&#945; (TNF-&#945;) gene expression on epididymal white adipose tissue and it had also a low hepatic concentration of this inflammatory marker, compared to HFHS group. These results suggest ellagitannins has an important role on reducing risk of obesity in HF/HS-fed mice, while jaboticaba CE seems to contribute on reduction of inflammation in these animals, but the mechanisms are still not understood.

A obesidade é um sério problema de saúde pública. Este estudo teve como objetivo avaliar o crescimento de camundongos fêmeas Swiss, oriundas do biotério do Departamento de Patologia da FMVZ-USP, que se tornam espontaneamente obesas, tentando identificar em que período se iniciam estas características de obesidade. Para isso, foram realizados dois experimentos: Exp. 1 - as fêmeas foram acompanhadas do dia pós-natal 303 (DPN 303) até o DPN 491; Exp. 2 - as fêmeas foram acompanhadas do DPN 1 até o DPN 240. No Exp. 1, os animais foram divididos em dois grupos: obesas (OB) e não obesas (NOB), todas receberam dieta padrão. No Exp. 2, ao completarem 21 dias de vida, as fêmeas foram divididas em 4 grupos: dieta padrão (DP), grupos DP-OB e DP-NOB e dieta hiperlipídica (DHF), grupos DHF-OB e DHF-NOB; receberam DHF somente durante a peripuberdade (DPN 21-DPN 60). Em ambos os experimentos foram realizados acompanhamento de peso corporal, acompanhamento de ingestão alimentar, medição de comprimento corporal e medição de circunferência abdominal. No DPN 470, foi realizado o teste de tolerância à insulina (TTI) e no DPN 472 o teste de tolerância oral à glicose (TTOG) nas fêmeas do Exp. 1 e da mesma forma nos DPN 230 e 232 nas fêmeas do Exp. 2. Foi realizado teste de suspensão pela cauda (TSC) nos animais do Exp. 2. Ao final dos experimentos foram realizadas dosagens séricas de triglicérides, colesterol total, AST, leptina e insulina, além das pesagens dos órgãos: gorduras gonadal e retroperitoneal, fígado, rim com adrenal e útero com ovários. Os resultados obtidos em cada experimento foram avaliados por meio de ANOVA de duas vias seguida do teste de Bonferroni e t Student, p<0,05. Em ambos os experimentos os animais obesos apresentaram maior comprimento corporal e circunferência abdominal, além de pesagem elevada dos órgãos fígado, rim e gorduras. As dosagens de leptina foram significantes para todos os animais obesos e as dosagens de triglicérides foram significantes nos grupos OB e DP-OB. No Exp. 1, houve diferença significante na resposta à insulina entre os grupos OB e NOB (TTI) e as fêmeas OB tiveram maior pico de glicemia aos 20 minutos de teste e permaneceram por mais tempo com os níveis glicêmicos elevados (TTOG); os animais do grupo OB tiveram aumento significante do ganho de peso corporal ao longo do tempo, atingindo 70g; as dosagens de AST foram significantes nos animais OB. No Exp. 2, os animais do grupo DP-OB tiveram aumento significante do ganho de peso corporal ao longo do tempo, mostrando ganho de peso elevado após o DPN 81; as dosagens de insulina foram significantes no grupo DP-OB em relação ao grupo DP-NOB; TSC não apresentou resultados significantes. Portanto, as alterações de ganho de peso elevado, maior crescimento corporal e maior circunferência abdominal podem ser observadas nas fêmeas DP-OB já no início da vida adulta. Entretanto, as alterações metabólicas aparecem somente em idade avançada (Exp. 1). Assim, mais estudos são necessários a fim de que se possa elucidar a origem das alterações fenotípicas encontradas / Obesity is a serious public health problem. This study aimed to evaluate Swiss female mice growth that were born in the Department of Pathology (FMVZ-USP) and became obesa spontaneously, trying to identify in which period these obesity signs start. Therefore, two experiments were conducted: Exp. 1 females were observed from post-natal day 303 (PND 303) to PND 491; Exp. 2 females were observed from PND 1 to PND 240. In the Exp. 1, animals were assigned to either one of two groups: obese (OB) and non-obese (NOB), where both groups received standard chow. In the Exp. 2, when females were 21 days old, they were assigned to either: standard chow (DP), DP-OB or DP-NOB groups, and high fat diet (DHF), DHF-OB and DHF-NOB groups; these animals received DHF only in the peripuberty period (PND 21- PND 60). Body weight gain, food intake, body length and abdominal circunference were measured in both experiments. In PND 470, insulin tolerance test (ITT) and PND 472 the oral glucose tolerance test (OGTT) were performed in the females from Exp. 1, and in PND 230 and PND 232, respectively, in the animals from Exp. 2. The tail suspension test (TST) was performed in the animals from Exp. 2. In the end of experiments, blood levels of triglycerides, total colesterol, AST, leptin and insulin were evaluated and the following organs were weighted: gonadal fat pad, retroperitoneal fat pad, liver, kidney including adrenals and uterus with ovaries. Results were analysed by two-way ANOVA with Bonferroni post-test and t Student test, p<0.05. Obese animals in both experiments showed bigger body length and abdominal circunference, including heavier organs such as liver, kidney and fat pads. Leptin levels were significant higher in all obese animals and triglycerides levels were significant in OB and DP-OB groups. In the Exp. 1, there was a significant diference in the response to insulin injection in between groups OB and NOB (ITT) and OB females reached higher glicemic levels 20 min after the glucose administration, keeping these levels high longer (OGTT); OB females showed a significant increase in the body weight gain over time, reaching 70g; AST levels were significant in OB animals. In the Exp. 2, animals from DP-OB group had significant higher body weight significant in the DP-OB group comparing to DP-NOB; there was no significant results in the TST. Therefore, heavier body weights, bigger body length and bigger abdominal circunference were observed in DP-OB females in the beginning of adult life. However, metabolic alterations can be detected only in late adult life (Exp. 1). Thus, more studies need to be done aiming to clarify the origin of the phenotypic alterations found here

As ondas de calor relatadas no climatério apresentam alta prevalência e afetam de forma significativa a qualidade de vida das mulheres acometidas. O climatério pode cursar com obesidade, hipertensao, diabetes mellitus tipo II e outros fatores de risco cardiovascular, que, em conjunto, compõem a síndrome metabólica, e que pode estar relacionada à maior ocorrência de ondas de calor. O presente estudo tem por objetivo estimar a prevalência de ondas de calor, bem como verificar sua relacao com a síndrome metabólica, em mulheres no climatério residentes em Pindamonhangaba, SP. Assim, em estudo transversal realizado à partir de um banco de dados de um projeto denominado PROSAPIN (PROjeto de SAúde de PINdamonhangaba) foram analisadas 900 mulheres de 35 a 65 anos - período conceituado como climatério (Notelovitz 1988). Todas as participantes foram avaliadas por meio da escala de Kupperman para quantificar os sintomas climatéricos e pelos critérios do ATPIII, para firmar o diagnóstico de síndrome metabólica. A prevalência de ondas de calor foi de 53,89% (IC95%: 50,62% - 57,15%). Por meio de um modelo de Regressao de Poisson múltipla, ainda se constatou nítida associacao da presenca de ondas de calor com síndrome metabólica, insonia, depressao, estresse e raca negra e parda. Em conclusao, as ondas de calor apresentaram alta prevalência na populacao estudada e se associaram a distúrbios emocionais, à raca e à síndrome metabólica. / Vasomotor symptoms or hot flushes are very prevalent in the climacteric period and significantly worsen the quality of life of the women affected. Climacteric can occur with obesity, hypertension, type II diabetes mellitus and other cardiovascular risk factors, which, together, represents the metabolic syndrome, that appear to be related to a higher occurrence of hot flushes. The present study aims to estimate the prevalence of hot flashes, as well as to verify its relationship with the metabolic syndrome, among climacteric women resident in Pindamonhangaba, SP. Thus, a cross-sectional study from a database of a project called PROSAPIN (PINdamonhangaba`s Health Project) analyzed 900 women from 35 to 65 years-old - a period known as climacteric (Notelovitz 1988). All participants were evaluated through the Kupperman scale to quantify the climacteric symptoms and through the ATPIII criteria, to establish the diagnosis of metabolic syndrome. The prevalence of hot flushes was 53,89% (CI95%: 50,62% - 57,15%), and, by a multiple Poisson regression model, it was observed a clear association between the presence of hot flushes and metabolic syndrome, insomnia, depression, anxiety and afrodescendence. In conclusion, the hot flushes presented high prevalence in the study population and were associated with emotional disorders, ethnicity and to the metabolic syndrome.

A Síndrome Metabólica (SM) é um transtorno complexo representado por um conjunto de fatores de risco cardiovascular, usualmente relacionados à deposição central de gordura e à resistência à insulina. Hipertensos com SM apresentam alta prevalência de lesões de órgãos-alvo e amplificação dos riscos cardiovasculares, com impacto prognóstico adverso. Este estudo descritivo, desenvolvido na Unidade Mista de Saúde de um município do interior paulista, teve como objetivo identificar os componentes de SM entre portadores de hipertensão arterial sistêmica e comparar a ocorrência dos fatores de risco associados à SM na população hipertensa e normotensa. Os aspectos adotados para a definição de SM foram os definidos pelo National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). As variáveis investigadas foram os dados sócio-demográficos, os valores de pressão arterial, cintura abdominal, glicemia, HDL colesterol e triglicerídeos plasmáticos. As análises descritivas, com cálculo de freqüências absolutas e porcentagens, foram realizadas por meio do pacote estatístico SPSS, versão 15.0. Utilizou-se o teste t de Student para comparações das médias dos dados quantitativos. Os resultados foram expressos como médias ± erros padrões das médias, e as diferenças consideradas estatisticamente significantes para p<0,05. A amostra foi composta por 261 participantes, classificados em normotensos (35,6%) e hipertensos (64,4%). A maioria dos participantes é do sexo feminino (70,5%), natural do estado de São Paulo (72,4%), de cor branca (78,5%), analfabeta funcional (49,8%), vive com companheiro (66,7%) e possui antecedentes familiares de doenças cardiovasculares (75,1%). A média de idade foi de 49 anos para o grupo normotenso e 58,8 anos para o grupo hipertenso. A SM esteve presente em 119 indivíduos, representando uma prevalência global de 45,6%. Identificamos a presença de SM em 60,7% dos hipertensos e em 18,3% dos normotensos. Comparado ao grupo normotenso, os portadores de hipertensão arterial apresentam, além da elevação da pressão arterial sistólica (p<0,001) e diastólica (p<0,001), diferença significante nos valores de circunferência abdominal (p<0,001), glicose (p<0,05) e triglicérides (p<0,05). Valor aumentado de circunferência abdominal foi o fator prevalente na amostra global e entre os portadores de hipertensão arterial. Em ambos os grupos, indivíduos do sexo feminino apresentam maior percentual de ocorrência de todos os componentes da SM. Considerando a combinação dos componentes da SM, ambos os grupos apresentaram como elementos mais frequentes baixos níveis de HDL-C + hipertrigliceridemia + obesidade abdominal. Conclui-se que a frequência dos riscos cardiometabólicos associados à SM é maior na presença de doença hipertensiva. Indivíduos que apresentam SM compartilham aspectos fisiopatológicos de alto risco para o desenvolvimento de doenças cardiovasculares. / Metabolic syndrome (MS) is a complex disorder represented by a set of cardiovascular risk factors. It is commonly associated with central adiposity and insulin resistance. Hypertensive patients with MS have high prevalence of target organ damage and amplification of cardiovascular risks, with adverse prognostic impact. This descriptive study, developed in the Joint Health Unit in an interior city, aimed to identify the components of MS among patients with hypertension and to compare the occurrence of risk factors associated with MS in normotensive and hypertensive population. Aspects adopted for the definition of MS were defined by the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III). The variables were the socio-demographic data, the values of blood pressure, waist circumference, blood glucose, plasma HDL cholesterol and triglycerides. The descriptive analysis, with calculation of absolute frequencies and percentages, were performed using the statistical package SPSS, version 15.0. We used the Student t test for comparisons of the average figures. Results were expressed as means ± standard errors of averages and differences considered statistically significant at p <0.05. The sample comprised 261 participants, divided into normotensive (35.6%) and hypertension (64.4%). Most participants were female (70.5%), a native of São Paulo (72.4%), white (78.5%), functionally illiterate (49.8%), lives with partner (66.7%) and have a family history of cardiovascular disease (75.1%). The average age was 49 years for the normotensive group and 58.8 years for the hypertensive group. MS was present in 119 individuals, representing an overall prevalence of 45.6%. Identified the presence of SM in 60.7% of hypertensive patients and in 18.3% of normotensive individuals. Compared to the normotensive group, patients with hypertension present besides the elevation of systolic blood pressure (p <0.001) and diastolic (p<0.001), significant differences in the values of waist circumference (p<0.001), glucose (p<0,05) and triglycerides (p<0.05). Increased value of waist circumference was the prevalent factor in the total sample and among patients with hypertension. In both groups, females have a higher percentage of occurrence of all components of MS. Considering the combination of components of MS, both groups presented as the most frequent low HDL-C + hypertriglyceridemia + obesity. It is concluded that the prevalence of cardiometabolic risk associated with MS is higher in the presence of hypertensive disease. Individuals that have SM share pathophysiological features of high risk for developing cardiovascular disease.

L’utilisation d’antagonistes du récepteur aux minéralocorticoïdes (ARM) a prouvé son efficacité dans le traitement de l’insuffisance cardiaque (IC). Un des facteurs de risque majeur de l’IC, le syndrome métabolique (SMet), est également associé à une production augmentée d’aldostérone et une activation excessive de son récepteur. Dans ce contexte, nous avons émis l’hypothèse que l’utilisation des ARM pouvait être appliquée pour cibler les facteurs de risques du SMet et prévenir la progression subséquente vers l’IC. Dans ce projet, des rats Spontanément Hypertendus et développant une IC (rats SHHF) portant ou non une mutation du récepteur de la leptine (« cp ») conduisant à un SMet (respectivement SHHFcp/cp et SHHF+/+) ont été utilisés comme modèle expérimental. Les animaux ont reçu soit un placebo soit le traitement ARM (Eplérénone, Eplé) dès l’âge de 1.5 à 12.5 mois et leurs paramètres métaboliques et cardiovasculaires ont été régulièrement évalués. Les fonctions moléculaires altérées dans le coeur et le tissu adipeux lors du développement du SMet et la progression de l’IC, ainsi que celles modulées par l’action de l’Eplé ont été caractérisées par l’analyse du transcriptome et miRNome des animaux. Nos résultats montrent que les rats SHHFcp/cp développent à 12.5 mois une hypertrophie cardiaque excentrique associée à une dilatation du ventricule gauche (VG) et une fraction d’éjection diminuée comparés aux SHHF+/+. Alors que l’Eplé ne modifie pas les paramètres métaboliques et cardiovasculaires des SHHF+/+, Les rats Eple-SHHFcp/cp présentent une moindre prise de masse corporelle ainsi qu’une moindre dyslipidémie. Sans effet sur la pression artérielle (PA), ni le transcriptome et miRNome adipeux, les animaux SHHFcp/cp traités présentent en outre une moindre dilatation et hypertrophie de leur VG, une fraction d’éjection, un temps de relaxation isovolumique et un ratio E/A plus élevés. Les analyses du transcriptome et miRNome cardiaques révèlent que l’Eplé induit une diminution significative de l’expression de gènes impliqués dans le remodelage et l’inflammation myocardiques ainsi qu’une augmentation de l’expression de gènes relatifs à l’oxydation des acides gras dans le coeur. L’intégration et l’exploration bioinformatique des profils d’expression du transcriptome et du miRNome ont permis d’établir des réseaux de régulation de l’expression génique potentiellement impliqués dans les mécanismes physiopathologiques à l’oeuvre chez les rats SHHF obèses et dans ceux impactés par le traitement. Dans leur ensemble, nos données montrent que l’initiation d’un traitement ARM lors du développement du SMet permet d’atténuer l’obésité et la dyslipidémie et d’améliorer les paramètres de structure et fonction cardiaque. De façon intéressante, ces effets cardioprotecteurs sont obtenus via des mécanismes indépendants de la diminution de la PA, les analyses du transcriptome/miRNome cardiaque indiquent un mécanisme basé sur une diminution des processus de remodelage et d’inflammation ainsi qu’ une restauration de la fonction de métabolisme énergétique des acides gras au niveau myocardique / Mineralocorticoid Receptor Antagonists (MRA) are clinically beneficial in individuals with chronic heart failure (HF). One of the major risk factors for HF, the metabolic syndrome (MetS), has been also reported to be associated with increased aldosterone production and excessive MR activation. In this context, we hypothesized that the use of MRA could be applied to target the MetS features and prevent the subsequent progression towards HF. In this project, Spontaneously Hypertensive Heart failure rats (SHHF) carrying or not a mutation in the leptin receptor (« cp ») leading to MetS development (SHHFcp/cp and SHHF+/+respectively) were used as experimental model. Animals from both genotypes were given either the selective MRA (Eplerenone, Eple) or placebo from 1.5 to 12.5 months of age and their metabolic and cardiovascular parameters were regularly monitored. The molecular functions altered in the heart and visceral adipose tissues as MetS develops and progresses towards HF as well as those modulated by Eple action were characterized by the analysis of animal’s transcriptome and miRNome. Our data showed that SHHFcp/cp exbiting MetS developed at 12.5 months of age eccentric cardiac hypertrophy associated with left ventricular (LV) dilatation and reduced ejection fraction (EF) as compared to SHHF+/+. While Eple did not induced differences in metabolic and cardiovascular phenotypes in SHHF+/+ rats, Eple-SHHFcp/cp had lower body weight gain and less dyslipidemia. Without effects on blood pressure (BP) and adipose transcriptome and miRNome, Eple-SHHFcp/cp rats had lower LV dilatation and hypertrophy, higher ejection fraction, isovolumic relaxation time and E/A ratio. Transcriptome and miRNome analysis of cardiac tissues revealed that Eple markedly reduced the expression of several genes involved in cardiac remodeling and inflammatory processes and increased the expression of genes related to cardiac fatty acid oxidation and metabolism. The integration and the bioinformatic exploration of transcriptome and miRNome expression profiles allowed the construction of gene regulatory networks potentially involved in the physiopathological mechanisms occuring in the SHHFcp/cp rats and those impacted by the treatment. Altogether, our data demonstrated that treatment with Eple during MetS development attenuated SHHFcp/cp weight gain and dyslipidemia contributing to the amelioration of their cardiac structural and functional parameters. Interestingly, those beneficial cardioprotective effects were obtained via mechanisms independent of BP lowering, the analysis of cardiac transcriptome/miRnome revealed that Eple may have acted by depressing cardiac remodeling and inflammatory processes and restoring the function of fatty acid metabolism in the myocardium

L'obésité, un problème de santé mondial, est associée à des comorbidités telles que le syndrome métabolique, la stéato-hépatite non alcoolique, la cardiomyopathie métabolique etc. Leur incidence et développement peuvent être le résultat des interactions gènes-environnement. Ces dernières années, une série d’études expérimentales et cliniques ont montré l’implication de donneurs de méthyles dans ces pathologies via la programmation fœtale. Notre travail a évalué, à la fois le rôle de donneurs de méthyles et le profil métabolique dans une population d’obèses, puis sur un modèle animal de ratons avec une carence en donneurs de méthyles, soumis à la vie adulte à un régime hyper-énergétique. Chez l’homme, nous avons démontré qu’une carence en vitamine B12 associée à un excès de folates est liée à l’insulino-résistance. Puis, nous avons observé des anomalies du métabolisme des acides gras. Chez l’animal, nous avons montré que la carence en donneurs de méthyles provoque une hypertension artérielle systémique et une fibrose cardiaque, surtout chez les femelles. Par contre, chez les mâles, nous avons observé une stéatose hépatique dans le groupe des rats mâles carencés et soumis à un régime hyper-énergétique. En conclusion, la carence en donneurs de méthyles est associée aux maladies chronico-dégénératives. / Obesity, is global health problem, is associated with comorbidities such as metabolic syndrome, nonalcoholic steatohepatitis, metabolic cardiomyopathy etc. Their incidence and development may be the result of gene-environment interactions. In the last years, the experimental and clinical studies have shown the involvement of methyl donors in these pathologies via « fetal programming ». Our work has evaluated the role of methyl donor on metabolic profile in obese subjects, and also in an animal model of pups with a deficiency of methyl donors, subject to high-fat diet in adulthood. In humans, we have demonstrated that vitamin B12 deficiency associated with excess in folates, is linked to insulin resistance. Also the methyl donors have an influence on fatty acid metabolism. In animals, we have shown that deficiency of methyl donors causes systemic hypertension and cardiac fibrosis, especially in females. In contrast, the males methyl donor deficient with a high fat diet had an important steatosis. In conclusion, the methyl donor shortage is associated with chronic degenerative diseases.

The purpose of this study was to determine if resistance exercise altered peripheral BDNF concentration. Eighteen trained male subjects were split into two groups performing varied repetition ranges. DUP-HR and DUP-LR groups trained 3x/week for 8 weeks, and were equated for total volume (repetitions X sets X intensity). Plasma BDNF and interleukin-6 (IL-6) levels were measured prior to and immediately following the first exercise session of weeks 1, 2, 4 and 6. Pre-exercise levels were also assessed prior to the second and third sessions of week 1 and 6. Lastly, resting levels were measured before and after training intervention. No group differences (p>0.05) were detected for either biomarker. An acute BDNF elevation (p=0.018) was detected only in the final week of training. IL-6 elevations were detected at all acute measurements (p<0.01). BDNF and IL-6 percentage change correlated significantly (p<0.05) in week-1. No chronic alterations were observed (p>0.05). / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2015 / FAU Electronic Theses and Dissertations Collection

Obesity is associated with elevated levels of the pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), contributing to systemic insulin resistance. Fibroblast growth factor 21 (FGF21) is a vital metabolic and inflammatory regulator, however circulating FGF21 concentrations are elevated in obese individuals. Acute aerobic exercise increases systemic FGF21 in normal-weight individuals, however the effect of acute aerobic exercise on plasma FGF21 response and the relationships with inflammation (IL-6 and TNF-α), insulin resistance, and energy expenditure in obese individuals is unknown. Following 30 minutes of treadmill running at 75% VO2max, plasma FGF21 response, as indicated by area-under-the-curve “with respect to increase” (AUCi) analyses, was attenuated in 12 obese compared to 12 normalweight subjects. Additionally, FGF21 AUCi positively correlated with glucose AUCi, total relative energy expenditure, and relative VO2max, suggesting that cardiorespiratory fitness levels may predict FGF21 response, contributing to the enhanced regulation of glucose and energy metabolism. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2014. / FAU Electronic Theses and Dissertations Collection